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Documentation, Coding and Billing

Partner Industry Webinar: Strategic Importance of Appropriate Documentation, Coding and Billing

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes

Doctors must stop blaming EHRs for clinical documentation shortcut failures

With copy and paste rampant, UW Health chief medical information officer Shannon Dean says toolkits and vendors can help, but physicians need to take responsibility for proper clinical documentation.

Overuse of copy and paste in electronic health records is a problem. Sure, it’s convenient. And it’s entirely understandable why it’s a common shortcut used by scores of physicians. But it often results in note bloat – unwieldy patient records overflowing with repetitive documentation – that can potentially lead to serious safety risks.

“Copying or importing text increases the risk of including outdated, inaccurate, or unnecessary information, which can undermine the utility of notes and lead to a clinical error,” wrote researchers in a 2017 study in Journal of the American Medical Association.

[Also: EHRs are overflowing with copy-and-paste records, JAMA study shows]

The practice of copy and paste has to be reigned in, and one chief medical information officer, writing for the Agency for Healthcare Research and Quality, says that has to start with the physicians themselves.

Shannon Dean, MD, CMIO at University of Wisconsin School of Medicine and Public Health, penned a column this month for AHRQ’s Perspectives on Patient Safety. She began with an example of what can happen when notation gets lazy.

She cites the case of a 78-year-old man who, “with an alleged history of ‘PE’ (interpreted by the clinicians as pulmonary embolism) received an unnecessary CT scan to rule out a suspected ‘recurrence’ of pulmonary embolus.

[Also: NIST weighs in on EHR copy-and-paste safety]

“As it happens, years earlier, the abbreviation ‘PE’ had been used in the electronic note to indicate that the patient had had a physical examination, not a pulmonary embolism!” said Dean. “In a vivid example of copy and paste, once the diagnosis of pulmonary embolism was mistakenly given to the patient, it lived on in the EHR.”

Beyond the risks to patient safety, that also points to the unnecessary costs that can pile up when unwitting clinicians order tests that are based on erroneous and repetitive data.

Nonetheless, said Dean, too many clinicians still copy and paste as a habit: “Perhaps we are complacent about copy and paste because we remain unconvinced that there is a correlation between its use and patient safety.”

In her article, she surveys more than a dozen studies on the subject, and finds that published research into adverse outcomes isn’t as voluminous as one might expect, even if it’s understood, intuitively, that the practice isn’t ideal.

So “it is clear that much work remains to be done,” said Dean. She points to toolkits like the one put together by AHIMA, and the fact that Epic has rolled out functionality that can “identify the source of every character within a note, whether it is newly typed, imported from another source, or copied and pasted.”

Still, “I am aware of very few organizations that are actively using these tools to educate and mentor clinicians in a systematic way to improve documentation quality,” she said.

While more academic research would be welcome on the correlation between copy and paste and patient safety, she said, it’s fairly widely accepted that it’s a shortcut that should only be used sparingly and in specific instances.

Healthcare organizations need to start making use of resources such as AHIMA’s toolkits, Epic’s auditing features and innovations like natural language processing technology to help physicians do better with their EHR documentation.

She also points to the OpenNotes initiative, which continues to gain momentum, as another big opportunity: Giving patients the ability to read their own doctor’s clinical notes allows them to “hold us accountable for quality documentation.”

But at the end of the day, “physicians need to reestablish ownership of the accuracy of clinical documentation,” said Dean. “We must stop blaming the EHR for our carelessness and start educating ourselves about how to use documentation efficiency tools, including copy and paste, more responsibly.”

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

Topics:

Clinical, Electronic Health Records (EHR, EMR), Workflow

ACMSS Applauds House Passage of VA Medical Scribe Pilot Act; Urges Scribe Certification

#VeteransAffairsMedicalScribePilotActof2017

ORANGE, Calif., August 24, 2017. The American College of Medical Scribe Specialists (ACMSS) applauds the passage last Friday of a bipartisan bill in the U.S. House of Representatives to create a pilot study in Veteran’s Administration hospitals to determine whether using Medical Scribes to assist physicians will help shorten the VA’s notoriously long wait times and ease other patient service problems. ACMSS only asks that the Senate modify the language in the bill to ensure the VA employs only Certified Medical Scribe Specialists.

The purpose of The Veterans Affairs Medical Scribe Pilot Act of 2017 (HR 1848), introduced by Rep. Phil Roe, M.D. (R-Tenn.), is to create a two-year medical scribe pilot program under which VA will increase the use of medical scribes at ten VA medical centers, employing 30 scribes in all. It is hoped that the use of medical scribes in the program will reduce the amount of time physicians spend on daily documentation so that they may increase the number of patients physicians can see and the amount of time physicians are spending with each patient. Every 180 days during the two-year program the VA will be required to report to Congress the programs effect’s on provider satisfaction, provider productivity, patient satisfaction, average wait time and the number of patients seen per day.

After the bill’s passage, Roe, who is Chairman of the House Committee on Veterans’ Affairs and a physician, released a statement on the purpose of the legislation. “Since the VA waitlist scandal broke three years ago, I’ve examined several ways to improve patient care for veterans, and one that came up repeatedly in discussions was cutting down on the time physicians spend entering data,” Roe said. “Many private-sector physicians report the use of medical scribes has a positive and meaningful impact on their ability to see patients. Scribes can help input patient data and allow physicians to focus on patient care and use their time more efficiently. That’s why I introduced legislation to start a pilot program to examine whether or not the use of medical scribes would have similar positive effects in the VA.”

ACMSS agrees with all of the elements contained in the Act, but is sending a letter to the Senate Committee on Veterans Affairs, asking for one change before the bill goes to the Senate for a vote. “If this legislation is approved in the Senate and the program goes forward, employing Medical Scribes to assist physicians at the VA will undoubtedly improve efficiencies and have the positive effect the bill proponents desire, and more,” said ACMSS Executive Director Kristin Hagen. “However, in approving the language, ACMSS urges the Senate to insist that only Certified Medical Scribe Specialists be used in the program. Medical scribes provide real-time documentation and increase practice efficiencies in a great number of areas outside of clinical documentation, but they must be certified.”

ACMSS is an independent certifying organization and works in compliance with the Centers for Medicare and Medicaid Services (CMS) to meet national goals and initiatives of Meaningful Use of Certified Electronic Health Record Technology (CEHRT), and Medicare Access and CHIP Reauthorization Act (MACRA) and its Merit-Based Payment Incentive System (MIPS). Certified Medical Scribe Specialists also meet the “qualified people” standard in CEHRT and assist with the design and infrastructure to support ongoing transformative care and change.

The ACMSS certification program meets current and proposed CMS certification requirements toward use of EHRs through its Medical Scribe Certification & Aptitude Test (MSCAT). In addition to the overall certification exam, ACMSS provides specialty certifications in vascular medicine, dermatology, oncology, primary care, internal medicine, emergency medicine and general patient care, enabling access to all across the specialties.

“Employing Certified Medical Scribe Specialists is the best way that care providers get can ensure they get back the time and attention they need to join the evolution of the outpatient healthcare industry into a patient-centered system that focuses on integrative medicine, prevention, disease reversal and wellness,” Hagen said.

Please contact ACMSS directly at info@theacmss.org, visit our website at theacmss.org, or phone 800-987-3692 if you have any questions regarding the ACMSS program and/or materials.

$68 Billion in Medical Billing Errors Puts Physicians’ Livelihood in Jeopardy

SAN ANTONIO, TX (PRWEB) MAY 15, 2017

As many as 80 percent of all medical claims submitted to insurance carriers contain mistakes estimated at $68 billion (1). Approximately 55 percent of evaluation and management (E/M) claims are incorrectly coded resulting in $6.7 billion in improper Medicare payments.(2) Providers looking to avoid lost revenue and serious consequences are raising the training standards of its administrative staff seeking out those who have completed specialized training and certification offered by Practice Management Institute (PMI).

Watchdog agencies, enforcement, and penalties are on the rise, creating a high-risk environment for physicians. Tighter screening measures adopted by the Affordable Healthcare Act have resulted in 17,000 providers losing their license to bill Medicare (3). Doctors have ultimate responsibility for all claims billed under their unique provider number, and a physician’s signature on any claim is held as verification of the accuracy and legitimacy of each claim (4).

Increased scrutiny has prompted doctors and healthcare facilities to require their employees to become certified. From an enforcement perspective, staff who knowingly submit fraudulent claims for payment can be held liable (5).

David Womack, President and CEO of PMI, says, “It’s critically important that providers have well trained staff. The physician needs to have confidence that their personnel are running the business correctly so they can focus on quality patient care.”

Physicians dedicate their careers to quality patient care; most have had little exposure to the increasingly complex world of medical claims management. They rely on their billing and administrative staff to stay on top of the guidelines set forth by Medicare and third parties. PMI helps providers adopt higher training standards with specialized courses and certification exams that address these high-risk areas of practice administration.

Womack says, “Taking steps to successfully train and certify staff in these areas means physicians are more likely to submit accurate claims and receive correct payments for their services, and ensure that practice liability is minimized.”

About Practice Management Institute (PMI):

For more than 30 years, Practice Management Institute, also known as PMI, has helped physicians, hospital systems, medical societies, and educational institutions provide comprehensive education and training to medical office staff nationwide. By offering a variety of educational programs and professional certifications, PMI helps to build competency, compliancy, and effectiveness that assures the continued success of their clients.

Since PMI’s formation in 1983, more than 20,000 individuals have earned certification in one more areas of expertise. PMI is recognized by both the Centers for Medicare and Medicaid Services and the Department of Labor for training in: medical coding, third-party billing, office management, and compliance. PMI training helps ease the burden of running a successful medical practice through thorough education and up-to-date training for non-clinical staff, allowing physicians to focus on patient care to improve the experience of the patient. For more information, visit http://www.pmiMD.com.

About David Womack:

David Womack, President and CEO, has been instrumental in PMI’s continued success since 1991. He has helped PMI transition into a cutting-edge leader in medical office staff education and training while developing key relationships with healthcare organizations, hospitals, colleges, and medical societies across the country. His commitment to excellence has helped PMI become an industry leader recognized by both governmental organizations and healthcare systems across the country.

Sources:

1.    “Incorrect Medical Coding Corrupts the Core Data Used by Health Care Facilities, Has Negative Consequences Throughout Health Care Industry.” Integrated Healthcare Executive. N.p., n.d. Web. 05 May 2017.
2.     “55% of E/M Claims Incorrectly Coded – What’s Your EMR Software Doing to Help?” HealthFusion, June 24, 2014.
3.    The $272 Billion Swindle.” The Economist. The Economist Newspaper, 31 May 2014. Web. 05 May 2017.
4.    College, From The. “Who Is Liable for Coding Mistakes?” The Rheumatologist. N.p., 01 Oct. 2010. Web. 05 May 2017.
5.    U.S. Department of Justice Memo, “Individual Accountability for Corporate Wrongdoing” aka, the Sally Yates Memo, September 9, 2015.

Continue reading “$68 Billion in Medical Billing Errors Puts Physicians’ Livelihood in Jeopardy”

National MT Week: May 14-20

As we get ready for National MT week, let’s take a look at the importance [still] of the Medical Transcriptionist in today’s healthcare industry:

- A skilled workforce produces quality documentation. Healthcare documentation specialists (HDSs) and medical transcriptionists (MTs) ease the documentation burden from physicians.
- HDSs and MTs consistently achieve documentation accuracy rates higher than 99%,¹ and by harnessing this workforce’s expertise, clinicians’ time, coding, and revenue are optimized and the data governance strategy is strengthened.
- The narrative allows physicians the opportunity to add the qualitative information that provides context to the patient’s medical history and care. HDSs and MTs understand the complex story-telling of patient care and are experts in document standards and data capture.
- Your healthcare documentation team are highly skilled, analytical quality assurance specialists who provide risk management support in capturing healthcare encounters and making sure they are documented in a way that promotes clinical clarity and coordinated care.
- HDSs and MTs need to be positioned to ensure accurate documentation of care encounters and to identify gaps, errors, and inconsistencies in the record that may compromise care or compliance goals.
- HDSs’ and MTs’ body of knowledge is vast and includes pharmacology, human disease processes, anatomy and physiology, HIPAA, privacy and security, and diverse technologies used to capture health data.
- Certify to healthcare delivery that HDSs and MTs have the training and expertise to be valued among the allied health and HIM delivery teams by earning and maintaining your professional certification.

#NMTW #PrecisionMatters

KMGMA 2017

#MDSofKansas will once again be at the #KMGMA2017 Spring Conference (04/20/17) and we are looking forward to seeing YOU! Please stop by our booth and check out some of the great giveaways, and learn what we’ve been up to! We are saving many clinics and businesses lots of money on everyday fees. If you would like to save money, too, stop by and ask us how!

17 Scribe things to know!

As physicians look for ways to reduce the clerical load associated with EHR data entry, they are increasingly turning to medical scribes.

Scribes help physicians with EHR navigation, retrieval of diagnostic results, documentation and coding. This allows the physician to free up time for patient care.

Yet while the use of scribes is growing, the position remains minimally regulated. There are no requirements for certification, for instance. Any certification received by scribes is voluntary, and the minimum qualification to work as a scribe is a high school diploma.

Here are 17 things to know about scribes.

Basic duties and numbers

1. Scribes typically go with the provider into the exam room and document the patient’s encounter with the provider. The provider may also dictate the patient encounter to the scribe, and the scribe gathers data for the physician such as nursing notes, prior records, labs and radiology results, according to the American College of Emergency Physicians.

2. “Medical scribes do the bulk of documentation for the provider, says Michael Murphy, MD, cofounder and CEO of ScribeAmerica, which provides scribes to hospitals and medical practices. “They’re tracking down labs, they’re notifying of delays, they’re helping in scheduling appointments. They’re basically handling 80 to 90 percent of the ancillary duties for providers.”

3. The American College of Medical Scribe Specialists estimates 20,000 scribes were employed by the end of 2014, and it expects this number to grow to 100,000 scribes by 2020.

4. As of April 2015, at least 22 companies supplied scribes across 44 states, according to the Journal of the American Medical Association. The largest company is ScribeAmerica, with more than 5,000 scribes in more than 570 healthcare facilities across 44 states.

Benefits

5. A study published last year by the National Center for Biotechnology Information found physician productivity in a cardiology clinic was 10 percent higher when scribes were used. The study compared the productivity during routine clinic visits of 10 cardiologists using scribes versus 15 cardiologists without scribes. According to the study, physicians with scribes saw 9.6 percent more patients per hour than physicians without scribes. Physician productivity in a cardiology clinic, overall, was 10 percent higher for physicians with scribes.

6. This same study showed physicians with scribes generated an additional revenue of $24,257 by producing clinical notes that were coded at a higher level. Total additional revenue generated was $1.4 million at a cost of roughly $99,000 for the employed scribes.

7. Additionally, another study showed correlation between a scribes system and thousands of dollars in savings per patient. The study compared standard visits (20-minute follow-up and 40-minute new patient) to a scribe system (15-minute follow-up and 30-minute new patient) in a cardiology clinic. Direct and indirect revenue combined resulted in $2,500 more per patient with the use of scribes.

8. While the use of scribes has resulted in increased productivity and a revenue boost, evidence also suggests scribes may improve clinician satisfaction, as well as patient-clinician interactions, according to a study published in the Journal of the American Board of Family Medicine.

The authors identified five peer-reviewed studies from 2000-2014 assessing the effect of medical scribes on healthcare productivity, quality and outcomes. Three studies assessed the use of scribes in an emergency department, one assessed the use of scribes in a cardiology clinic and one assessed the use of scribes in a urology clinic. Two of the studies reported scribes improved clinician satisfaction, and one study reported improved patient-clinician interactions.

9. Dr. Murphy says scribes are helping alleviate productivity challenges associated with EHRs, but they are also helping providers through the transition to ICD-10 —the 10th version of the World Health Organization’s medical classification system that took effect Oct. 1, 2015.

Regulations

10. CMS does not provide official guidelines on the use of scribes, but has responded to direct inquiries about using scribes, according to the American College of Emergency Physicians.

11. CMS does not bar non-physician providers, such as physician assistants, nurse practitioners and clinical nurse specialists, from using scribes.

12. A scribe does not need to be employed by the hospital they work at, according to the American College of Emergency Physicians. Hospitals may use scribes to bridge volume gaps, enabling a smaller number of physicians to treat a greater volume of patients, says Dr. Murphy.

13. The provider must add and sign an addendum to the scribe’s note when the scribe makes an entry on a paper medical record and correction is needed, rather than cross out or alter what the scribe has written, according to the American College of Emergency Physicians.

14. The Joint Commission does not endorse or prohibit the use of scribes. The Joint Commission permits scribes to document the previously determined physician’s dictation and/or activities, but does not permit scribes to act independently, with the exception of obtaining past family social history and a review of systems, a technique providers use to get the patient’s medical history.

Education and training

15. As of January 2016, the average pay for a medical scribe is roughly $12 an hour, or $29,595 annually, according to PayScale. The Bureau of Labor Statistics does not provide salary information specific to medical scribes. However it does provide data for medical transcriptionists. According the bureau’s latest numbers available, from May 2014, the average pay for a medical transcriptionist is $17.11 an hour.

16. The general minimum qualification for medical scribes is a high school diploma, although some pre-med students work in medical scribe positions to gain experience from shadowing physicians, according to an article published by U.S. News & World Report.

17. Scribes are not required to go through a certification process. However, there are organizations, mostly scribe service vendors, that train and certify scribes, one of which is the American College of Medical Scribe Specialists. Read more…

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Vitamin K2: Heart and Bone Health

By Dr. Mercola

Most everyone, including many conventional physicians, have begun to appreciate the importance and value of vitamin D. Few, however, recognize the importance of vitamin K2, which is nearly as important as vitamin D.

Dr. Dennis Goodman,¹ who was born in South Africa and trained at the University of Cape Town, has multiple board certifications in cardiology (and several subspecialties) and holistic integrative medicine.

After his internship at the Grootte Schuur Hospital—where Dr. Christian Barnard did the first heart transplant in 1967—he came to the US, where he did his cardiology fellowship at the at the Baylor College of Medicine in Houston, where Dr. Michael DeBakey performed the first bypass surgery.

“I was really very lucky to be in a situation where I had these two cardiac giants as mentors and teachers,” he says.

Dr. Goodman is also the chairman of the Department of Integrative Medicine at the New York University (NYU), and has authored the book, Vitamin K2: The Missing Nutrient for Heart and Bone Health. In it, he explains why vitamin K2 isevery bit as important as vitamin D.

“For 20 years I was putting stents in; running around day and night at the hospital. When I got called to the emergency room for someone having a heart attack, I was like a fireman putting out a fire in a house.

Sometimes, you were very lucky and could save the house from burning down, and sometimes not.

What I started to realize is that prevention is really the key for us to making the maximum impact. I’ve always been interested in the idea that everything we need to be healthy is provided by the Lord above –namely what’s out there for us to eat.

80 percent of these chronic diseases including atherosclerosis, heart attacks and strokes, diabetes, and obesity are preventable. So I got into the whole idea of learning integrative medicine,” he says.

He was the chief of cardiology at Scripps Memorial, and went on to Scripps Clinic for Integrative Medicine for many years.

“Obviously, when you understand holistic medicine, you understand that so much of what we’re doing, unfortunately, in traditional medicine is procedures, testing, and prescribing drugs, because that’s what we’re taught—and making diagnoses instead of taking care of people who basically may not have a disease, but are not healthy and well.”

As a cardiologist, it’s quite appropriate to delve into vitamin K2, as it has two crucial functions: one is in cardiovascular health and the other is in bone restoration.

It performs many other functions as well, but by helping remove calcium from the lining of the blood vessels, vitamin K2 helps prevent occlusions from atherosclerosis.

Vitamin K Basics

Vitamins K1 and K2 are part of a family, but they are very different in their activity and function. Vitamin K1, found in green leafy vegetables, is a fat-soluble vitamin involved in the production of coagulation factors, which are critical for stopping bleeding.

This is why when someone’s on a blood thinner such as warfarin, they need to be careful not to take too much vitamin K1, as it will antagonize the effect of drug. Vitamin K2 is very different. There’s a complex biochemistry that occurs with K2 involving two enzymes:

Matrix Gla-protein (MGP)

Osteocalcin

“Gla” is short for glutamic acid. Glutamic acid is imported into the cells in the wall of your arteries, where it binds to calcium and removes it from the lining of your blood vessels.

Once removed from your blood vessel lining, vitamin K2 then facilitates the intergration of that calcium into your bone matrix by handing it over to osteocalcin,. The osteocalcin then helps cement the calcium in place.

Vitamin K2 activates these two proteins. Without it, this transfer process of calcium from your arteries to your bone cannot occur, which raises your risk of arterial calcification.

“Vitamin K2 is like a light switch—it switches on MGP and osteocalcin, which takes calcium out of the arterial wall and keeps it in the bone.

There’s so much information showing this relationship between osteoporosis (not having enough calcium in your bones) and having an increased incidence of heart disease. What’s actually happening, I think, a lot of patients are vitamin K2-deficient,” Dr. Goodman says.

“So now, I tell all patients – especially when they have risk factors for calcification – ‘You’ve got to get vitamin K2 when you take your vitamin D, and your calcium, and magnesium.’ Because we need to make sure that the calcium is going where it’s supposed to go.”

Statins May Increase Arterial Calcification by Depleting Vitamin K2

Besides a vitamin K2-poor diet, certain drugs may affect your vitamin K2 status. Dr. Goodman cites a recent article² in the Journal of the American College of Cardiology, which suggests statin drugs may increase calcification in the arteries.

Interestingly enough, another recent study³ published in the Expert Review of Clinical Pharmacology shows that statins deplete vitamin K2.

“For me, that is so huge because if that’s true, everybody that is put on a statin, you want to make sure they’re also taking vitamin K2,” Dr. Goodman says.

This is an important observation, considering one in four adults in the US over the age of 40 is on a statin drug. Not only do all of these people need to take a ubiquinol or coenzyme Q10, which is also depleted by the drug, it’s quite likely they also need vitamin K2 to avoid cardiovascular harm.

Sources of Vitamin K2

Vitamin K2 is produced by certain bacteria, so the primary food source of vitamin K2 is fermented foods such as natto, a fermented soy product typically sold in Asian grocery stores. Fermented vegetables can be a great source of vitamin K if you ferment your own using a specially-designed starter culture. My Kinetic Culture is high in strains that make vitamin K2. If you would like to learn more about making your own fermented vegetables with a starter culture, you can watch the video and read more on this page.

Please note that not every strain of bacteria makes K2, so not all fermented foods will contain it. For example, most yogurts have almost no vitamin K2. Certain types of cheeses, such as Gouda, Brie, and Edam, are high in K2, while others are not. It really depends on the specific bacteria. Still, it’s quite difficult to get enough vitamin K2 from your diet—especially if you do not eat K2-rich fermented foods—so taking a supplement may be a wise move for most people.

How Can You Tell if You’re Deficient in Vitamin K2?

The major problem we face when it comes to optimizing vitamin K2 is that, unlike vitamin D, there’s no easy way to screen or test for vitamin K2 sufficiency. Vitamin K2 cannot at present be measured directly, so it’s measured through an indirect assessment of undercarboxylated osteocalcin. This test is still not commercially available, however. “That’s our problem. If that was available, we could start testing and showing people that their levels are low,” Dr. Goodman says.

Without testing, we’re left with looking at various lifestyle factors that predispose you to deficiency. As a general rule, if you have any of the following health conditions, you’re likely deficient in vitamin K2:

Osteoporosis

Heart disease

Diabetes

That said, it’s believed that the vast majority of people are in fact deficient these days and would benefit from more K2. One reason for this is very few (Americans in particular) eat enough vitamin K2-rich foods. So, if you do not have any of the health conditions listed, but do NOT regularly eat high amounts of the following foods, then your likelihood of being vitamin K2 deficient is still very high:

Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria

Certain cheeses such as Brie and Gouda (these two are particularly high in K2, containing about 75 mcg per ounce)

Grass-fed organic animal products (i.e. egg yolks, butter, dairy)

Different Kinds of Vitamin K2

The vitamin K puzzle is even more complex than differentiating between K1 and K2. There are also several different forms of vitamin K2. The two primary ones—and the only ones available in supplement form—are menaquinone-4 (MK-4) and menaquinone-7 (MK-7). MK-4 has a very short biological half-life—about one hour—making it a poor candidate as a dietary supplement. MK-7 stays in your body longer; its half-life is three days, meaning you have a much better chance of building up a consistent blood level, compared to MK-4.

In supplement form, the MK-4 products are actually synthetic. They are not derived from natural food products containing MK-4. The MK-7– long-chain, natural bacterial-derived vitamin K2– on the other hand comes from a fermentation process, which offers a number of health advantages.

Research⁴ has shown MK-7 also helps prevent inflammation by inhibiting pro-inflammatory markers produced by white blood cells called monocytes. MK-7 is extracted from the Japanese fermented soy product natto, and since it’s longer lasting, you only need to take it once a day. With an MK-4 supplement, you need to take it three times a day. The duration of action is also much longer with MK-7.

As for a clinically useful dosage, some studies have shown as little as 45 micrograms per day is sufficient. Dr. Goodman recommends taking 180 micrograms per day, making sure the K2 is in the form of MK-7. If you’re eating natto, all you need is about one teaspoon.

That said, vitamin K2 is non-toxic, so you don’t need to worry about overdosing if you get more. Do keep in mind that vitamin K2 may not necessarily make you “feel better” per se. Its internal workings are such that you’re not likely to feel the difference physically. Compliance can therefore be a problem, as people are more likely to take something that has a noticeable effect. This may not happen with vitamin K2, but that certainly does not mean it’s not doing anything! Last but not least, remember to always take your vitamin K supplement with fat since it is fat-soluble and won’t be absorbed without it. Read More

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Scribes Can Alleviate Doc Burnout

Certified Medical Scribe Support Can Alleviate Physician EHR Burnout Concerns; Certify Today

CONTACT: Kristin Hagen
President/CEO, American College of Medical Scribe Specialists
(657) 888-2158

ORANGE, CA., July 6, 2016. According to a new analysis by the Mayo Clinic and American Medical Association researchers of a nationwide survey of physicians, computerized provider order entry and electronic health record use are a major source of burnout for physicians. The study found that physicians who used EHRs and CPOE had greater rates of burnout than those who did not, an issue that Certified Medical Scribe Specialists (CMSS) have been shown to help alleviate.

“This study makes it clear that physicians are frustrated with the drop in productivity resulting from electronic health record use and the time takes away from true, face-to-face interactions with patients,” said ACMSS Executive Director Kristin Hagen. “The revolution in our healthcare system toward value-based, individualized medical care and treatment cannot happen if the EHRs meant to help facilitate these changes are a major source of physician dissatisfaction. Certified Medical Scribe Specialists assist practices and clinicians in real time, assisting innovative workflow and efficiencies, providing necessary tools and resources.”

A study published last fall in ClinicoEconomics and Outcomes Research found that physician productivity in a cardiology clinic was 10% higher for physicians using medical scribes. This improved productivity resulted in 84 additional new and 423 additional follow-up patients seen in one year. That study also found that the physicians using medical scribes finished most or all of their work during clinic hours and they did not have to spend additional time to complete documentation after their standard working hours.

“The clinical documentation and practice efficiencies certified scribes provide have been shown to ease the clerical burdens of CPOE and EHRs, and give physicians back the time and attention they need focus on their patients,” Hagen said. “Providers need to ensure that they use certified medical scribes, meeting CMS requirements, revolutionizing clinical care and creating sustainable outcomes together.”

The ACMSS certification program meets current and proposed CMS certification requirements toward use of electronic health records. ACMSS works in compliance with CMS to meet national goals and initiatives of Meaningful Use, Merit-Based Payment Incentive System (MIPS) and Medicare Access and CHIP Reauthorization Act (MACRA). Certified medical scribes also meet the “qualified people” standard in Certified Electronic Health Record Technology (CEHRT). If not the clinicians themselves entering the data, eligible personnel must be certified, meeting the CEHRT Meaningful Use (MU) Personnel standard.

The ACMSS certification program meets current and proposed CMS certification requirements toward use of EHRs through its Medical Scribe Certification & Aptitude Test (MSCAT). ACMSS provides specialty certifications in vascular medicine, dermatology, oncology, primary care, internal medicine, emergency medicine and general patient care, enabling access to all across the specialities. ACMSS enables same-day certification for practices to meet Meaningful Use attestations, presently at 2%, and offers ongoing webinars to assist prospective individuals with key information about ACMSS, regulations, and innovations to meet healthcare goals through Volume Certification Packages.

Building integrative systems design for prevention and disease reversal for patient care most heavily impact family practice, primary care, and urgent care, followed by all the specialities. MIPS and MACRA allow the current traditional healthcare system and providers to focus on their much-needed goals today in independent practices of working to assist patients in disease reversal and prevention toward wellness.

The American College of Medical Scribe Specialists offers five separate pathways for Certified Medical Scribe Specialists. Please contact ACMSS directly atsupport@theacmss.org or 657-888-2158 if you have any questions regarding the ACMSS program and/or materials.

About ACMSS

The American College of Medical Scribe Specialists is the nation’s only nonprofit professional society representing more than 17,000 Medical Scribes in over 1,700 medical institutions. ACMSS partners with academic institutions, non-profit partners, and medical scribe corporations to offer both education-to-certification and employment-to-certification pathways. ACMSS advances the needs of the medical scribe industry through certification, public advocacy, and continuing education. To learn more about ACMSS, please visit: theacmss.org

ACMSS
support@theacmss.org
(657) 888-2158

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Certified Medical Scribe Specialists (CMSS) credentials and certification are enabled via the Medical Scribe Certification & Aptitude Test (MSCAT), recognized by CMS, meeting the Personnel Measure of Eligible Personnel of “who” may document in the EHR.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Azalea® Telehealth

Engage with patients and other providers using Azalea’s secure, video-conference platform.

Azalea Health / Azalea® Telehealth

“We are very excited about Azalea’s telehealth solution and love how it’s fully integrated with our EHR and patient records. We immediately can increase care coordination, communication and even patient safety, which all leads to improved care quality, better outcomes and increased patient satisfaction.”

Leigh Ritorto, VP of Clinical Services, Women’s Telehealth

Azalea Health now offers fully integrated telehealth functionality within its certified electronic health record (EHR) solution. Azalea Health is the first health IT company to successfully integrate telemedicine functionality into its EHR solution and provide innovative services to its users as a part of a complete interoperable cloud-based health IT platform.

This additional functionality allows for increased physician-patient engagement through live streaming video calls via a secure, HIPAA-compliant videoconferencing platform. Azalea’s telehealth features allow direct media streaming, not only between care providers and their patients, but also between healthcare providers in other organizations. These features are accessible using a mobile/smart phone.

Since Azalea’s virtual care solution is an integral part of our comprehensive health IT platform, it has the essential and inherent integration into all clinical, financial and administrative workflows. Our solution is not only fully integrated with our certified EHR, but also fully integrated with our patient portal, mobile apps and billing to facilitate patient engagement, care coordination and capitalize on chronic care management reimbursement guidelines.

Download the Telehealth Info Guide.

To learn how you can get started with Azalea EHR with Telehealth functionality, contact us atInfo@AzaleaHealth.com or call 877-777-7686.

Telehealth Benefits

Increased accessibility and convenience of providing patient consultations and physician collaborations

Increased reimbursements through CMS’ Chronic Care Management program

Improved clinical operations due to integrated software and hardware workflows

More efficient care delivery than traditional visits alone

Opportunity to reduce readmission rates

Improved care coordination

Enhanced patient engagement

Increased reimbursement rates

Telehealth Features

Easy-to-use

Live streaming video calls via a secure, HIPAA-compliant videoconferencing platform

Direct media streaming

Accessible using a mobile/smart phone

Fully integrated with Azalea’s certified EHR, patient portal, mobile apps and billing functionality

Azalea® Telehealth Solution screenshots:

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Transcription Market Share Analysis

Lower Volumes, But More Stable Outlook

JOHNSON CITY, TN — Of the estimated 2.1 billion patient encounters documented in the United States in 2015, approximately 32%, or over 670 million documents, were generated by dictation and transcription, according to a new market analysis from WebChartMD.

The analysis (click here to access) breaks out the clinical documentation market into the three main documentation methods most often used by healthcare providers: 1) Provider Entry, in which the healthcare provider enters data him/herself into the EHR; 2) dictation and transcription; and 3) Scribe Entry, in which Medical Scribes enter data into the EHR. Front-end speech recognition usage was not included in the study.

Provider Entry is the leading clinical documentation method, with an estimated 61% market share, followed by dictation and transcription, with an estimated 32%. Scribe Entry trails with an estimated 7% market share.

Dictation and transcription, the second most-used modality, had its heaviest concentration of usage in ambulatory specialty care and hospital-based documentation. The medical transcription industry had estimated 2015 sales of $2.2 billion, or 20.6 billion annual lines. About 30% of all US-based physicians – or just over 300,000 – continue to use dictation and transcription for some percentage of their clinical documentation, according to a recent WebChartMD estimate.

A notable change in the break-out of market share has been the rise of the Scribe Entry segment, which has grown from a few thousand to over 20,000 Scribes nationwide in just the last few years. Scribes currently process an estimated 143 million patient encounters annually, or about 7% of the entire clinical documentation market.

One take-away from the analysis? “The government has spent billions of dollars since the 2009 HITECH Act to incent physicians to adopt EHR-based clinical documentation tools. Despite that, there remains a sizable minority of healthcare providers who continue to use dictation and transcription,” said Christensen. “While transcription will never return to its former levels of usage, I believe there are a number of specific reasons why it will persist as a clinical documentation modality.”

About WebChartMD

WebChartMD, a software development company specializing in clinical documentation workflow applications, partners with over 100 MTSOs nationwide, which in turn serve over 8,000 physicians via the WebChartMD platform.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Highlights From The 2016 State of The Medicine Address

GomerBlog highlights the major points from tonight’s State of The Medicine Address given by the President of Hospital Administrators, Mr. Cutter Salary.

Hospitals now have the highest patient satisfaction in the history of healthcare and probably correlates to increased quality of care according to patients and lawmakers

WiFi, fast food restaurants, and pianos are distributed throughout hospital lobbies replacing exam rooms and useless medical equipment

Doctors now spend 50% of their time coding which is a vast improvement over last year and has led to spectacular reimbursement rates to enable hiring of more administrators. Remember Caring IS Coding!

Unnecessary Nurse bonuses were removed in a major cost saving move this year. To save even more money, cuts will start with the nursing staff and end with the nursing staff

More paperwork was passed by the Joint Commission providing critical safety measures requiring timeouts before codes to prevent wrong sided CPR

Drinks were finally stripped from the Nursing Station. This year we must continue with stripping any fun or laughter from the Station. We don’t want our patients thinking we are making fun of them

Breaks are vanishing from the workplace and we need to continue that for our medical providers. Foley catheters were distributed to staff to help our providers perform flawless and uninterrupted care

Surgeons are required to perform 3 more surgeries a day and leave when it is dark outside. Skin cancer rates are drastically down in our employees now thanks to this move.

Patient to Nurse ratios are at an all-time high providing a challenging and dynamic work environment to our nursing staff, which we know they enjoy

Physicians are burning out quicker than ever and we are replacing them with cost cutting google university graduated patients

The new Secretary of The Medicine, Dr. Oz, continues to utilize his charismatic charm to educate the public before they come to the hospital

And finally, our budget has been passed and includes hiring another 1.2 million hospital administrators to oversee and provide outstanding medical care to our hospitals!

“God Bless The Medicine and God Bless my obnoxiously large pension!”
READ MORE

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

Azalea Health EHR 2.1 Earns ONC-HIT Certification for all 64 CMS Clinical Quality Measures

Azalea Health EHR 2.1 Earns ONC-HIT Certification for all 64 CMS Clinical Quality Measures

November 17, 2015Terry SirokyNews, Press Releases

ATLANTA, GA – (November 18, 2015) – Azalea Health’s solution, Azalea EHR 2.1, is one of a select few EHRs to achieve certification on all 64 CMS clinical quality measures (CQMs). Eligible providers are required to report on CQMs to demonstrate meaningful use and receive an incentive payment under the Meaningful Use Stage 2 rule. The provider can select and report on nine from the list of 64 approved CQMs for the electronic health record (EHR) incentive programs.

“Our healthcare system is evolving rapidly towards quality and outcomes-based payments so it’s imperative for Azalea to ensure we offer the most innovative, flexible and functional EHR as well as quality reporting platform for physicians and other care providers,” said Baha Zeidan, CEO of Azalea Health. “The three main pillars of our company are innovation, partnership and leadership and this CQM certification embodies those pillars as we navigate our customers successfully through the future of healthcare.”

The Azalea 2.1 EHR includes fully integrated electronic health records, practice management, interoperability services, patient portal, personal health records, telehealth, and the AzaleaM mobile platform integrated with Apple® HealthKit, as well as revenue cycle performance services.

Azalea Health helps reduce the complexity of operating a medical practice, enabling physicians to spend more time with their patients. Azalea’s cloud-based solution is simple to implement and easy to use, streamlining administrative workflow while maximizing a practice’s resources and revenue cycle.

Certification Details

This Complete EHR is 2014 Edition compliant and has been certified by an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of the U.S. Department of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments.

Vendor name: Azalea Health

Date Certified: 10/8/2015

Product Version: Azalea EHR 2.1

Criteria Certified: 170.314 (a)(1‐15); (b)(1‐5, 7); (c)(1‐3); (d)(1‐8); (e)(1‐3); (f)(1‐3); (g)(2‐4) Certification ID Number: 10082015-3440-5

Clinical Quality Measures Certified: 2v4; 22v3; 50v3; 52v3; 56v3; 61v4; 62v3; 64v4; 65v4; 66v3; 68v4; 69v3; 74v4; 75v3; 77v3; 82v2; 90v4; 117v3; 122v3; 123v3; 124v3; 125v3; 126v3; 127v3; 128v3; 129v4; 130v3; 131v3; 132v3; 133v3; 134v3; 135v3; 136v4; 137v3; 138v3; 139v3; 140v3; 141v4; 142v3; 143v3; 144v3; 145v3; 146v3; 147v4; 148v3; 149v3; 153v3; 154v3; 155v3; 156v3; 157v3; 158v3; 159v3; 160v3; 161v3; 163v3; 164v3; 165v3; 166v4; 167v3; 169v3; 177v3; 179v3; 182v4

Any additional software relied upon to Certify: DrFirst Rcopia

*Price Transparency: Azalea 2.1 EHR – Monthly software subscription fee and one-time set-up & training fee.

*Azalea EHR 2.1 may require one-time costs to establish interfaces for reporting to immunization registries and public health agencies.

See the full press release at www.marketwired.com.

About Azalea Health

Azalea Health is a leading provider of fully integrated, technology-enabled healthcare solutions and managed services for practices of all sizes and most specialties. Azalea’s comprehensive portfolio includes integrated electronic health records, practice management, electronic prescribing, interoperability services, personal health records, patient portal, telehealth, AzaleaM mobile platform integrated with Apple® HealthKit, as well as revenue cycle performance services. The Azalea platform also provides tools and resources to help customers meet their Meaningful Use and ICD-10 requirements as well as strategies to navigate accountable care and alternative payment models. To learn more, please visitwww.AzaleaHealth.com, call (877) 777-7686 or connect via social media on Facebook, Twitter and LinkedIn.

Media Contact: Lynn Hood, lynn@crackerjack-marketing.com, 678-974-2623

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

TRANSFORMATION BY TELEHEALTH

Everywhere you look now, a telehealth stat or strategy is being written about or discussed. I realize not in every instance but in many where they are discussing evolutions in care coordination, improving outcomes, increasing patient satisfaction and certainly driving additional (and much needed) revenue.

Here are some of the recent news clips:

Primary care continues to see a boom in telehealth implementation with the infusion of non-traditional healthcare players such as Apple, Walmart, Walgreens, etc. into the space, which will continue

Since the ACA, remote patient monitoring has arisen as a method to reduce hospital readmissions and curb costs for providers. Many hospitals have sent patients home with remote monitoring devices so they can be observed at home for the post-30-day period and this method has saved money and reduced readmissions penalties drastically in some cases

Post-acute providers and hospitals have been more engaged in integrating telehealth into their services because they see the benefits as far as cost-savings and lowering readmissions

No matter the size of your hospital, surgery center, clinic or practice, you may want telehealth on your radar screen.

While potential costs are mentioned as a barrier (or excuse not to research), telehealth can be extremely affordable and simple to implement. The real “costs” may come when practices, hospitals and other organizations lose out on the additional revenue, care quality and incentives that come along with telehealth strategies.

There are even integrated solutions that exist today that place telehealth on provider desktops, tablets, and smartphones, enabling face-to-face video communications integrated into their clinical workflow that are as easy as a phone call to initiate or receive. Experts also suggest the fast growth of consumerism in healthcare as well as the increased use of mobile health applications will further promote telehealth strategies from the patient engagement perspective as patients seek to manage and coordinate their own care.

Here are a few strategies and best practices for investing in telehealth

Protect your market share. All but three states reimburse for telehealth encounters for their Medicaid programs, and 27 states have enacted laws that enforce coverage for services provided through telehealth. Although it is not mandated, many private insurers offer reimbursement for services delivered through telehealth.

Proposed rules for Meaningful Use Stage 3 treat a real-time patient encounter delivered through technology-assisted healthcare the same as a physical encounter. What’s more, the provider can also choose to include consultative services “such as reading an EKG, virtual visits, or asynchronous telehealth.”

The payer community has embraced telehealth to help patients receive the right care at the right time. Providers should do the same.

Increase revenue. Remote monitoring for patients with two or more chronic conditions not only can help patients live with their conditions more effectively, it also can increase the bottom lines of providers. The Centers for Medicare & Medicaid Services has developed CPT codes that allow providers to bill a monthly fee for monitoring patients with chronic illnesses.

CPT code 99490 allows for non-face-to-face care coordination services for those with a care plan listing multiple chronic conditions expected to last at least 12 months and place the patient at significant risk of death or decline. Average compensation is $42.60 monthly, based on geography. It can be used in conjunction with CPT code 99091 (collection and interpretation of physiologic data) for a $56.92 monthly reimbursement per patient.

Prepare for the future. The telehealth and home health technologies market is expected to quadruple in size over the next five years, growing to $13.7 billion by 2020, according to a market intelligence company that tracks the space with other reports predicting much higher growth.

Once considered a fringe technology, telehealth clearly has moved into the mainstream as a way to see patients who may be limited by mobility or geography, as well as those who prefer the convenience of a face-to-face video encounter. Another important use case that is growing is for provider-to-provider such as a primary care provider collaborating or coordinating care with a specialist locally or halfway around the world.

As many industry leaders and even disrupters are suggesting, organizations need to invest in telehealth phenomenon to effectively compete in the healthcare marketplace. But in order to truly fulfill its mission, telehealth must be convenient to providers. Any telehealth solution must be readily available, incorporated into the natural workflow of the provider and available on the device he or she uses. Read more…

Baha Zeidan is the co-founder and chief executive officer of Azalea Health Innovations.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

Health & You: Chemotherapy and Swimming

May 20, 2015 Dr.Pool

Chemotherapy is a cancer treatment that uses chemicals to blast cells. It’s not a blast of radiation, but a chemical treatment that targets cancer cells.

Chemotherapeutic agents kill cells that quickly divide – such as cancer cells. How do infections and chemotherapy and swimming all relate?

Chemotherapy

Chemotherapy and Infection Risk

Chemotherapy and Swimming

Chemotherapy

For over 50 years, chemotherapy or ‘chemical therapy’ has been a part of cancer treatment. Chemotherapy injections or pills can be used by itself or in addition to surgery or targeted radiation treatment. Surgery and radiation destroy the cancer cells in a given region, while chemotherapy works well throughout the body.

Cancer cells multiply at a quicker rate than normal cells; therefore chemotherapy is made to target multiplying cells. The more they divide, the stronger the effectiveness of the drug will be.

With chemotherapy comes the side effect of normal cells being destroyed as well. These cells can be found in the hair, mouth and intestines. Side effects of chemotherapy include exhaustion, mouth sores, nausea, hair loss and brittle nails.

Additionally, the immune system can become weakened which allows for more infections. Because of these risks and side effects that accompany chemotherapy, many patients can be devastated with the option of chemotherapy.

Cancer treatment in many cases requires the use and access of veins for different options for treatments – including chemotherapy, blood transfusions, antibiotics and intravenous fluids, or IV fluids. To make procedures and treatments such as these easier, doctors might recommend using a catheter or port, however these present another infection risk.

Cancer and Infection Risk

Infection occurs when germs are allowed to enter an moist opening on the body, multiplying and mutating. This is common with those who suffer from cancer, as the immune system is in a weakened state. Fortunately, there are many ways to prevent and treat possible infections.

Catheters are long plastic tubes that deliver treatments and drugs that can manage side effects and symptoms of cancer directly into a vein. Washing hands before you touch the catheter helps prevent infection. Germs from dirty hands can lead to germs getting into your system, which is worse when the immune system is weakened.

Other helpful tips include changing the bandages when necessary – as germs can build up on an old bandage. Prevent air from getting in the catheter by making sure the clamps are tight when the tube isn’t in use. Avoid breaks or cuts in the catheter, and keep the catheter from being underwater.

After a chemotherapy treatment is when one is most vulnerable to infectious disease. Viral infections like influenza or the common cold are easily transferred from person-to-person in crowded areas. Some ways to help prevent infection include washing hands often and avoid touching hands to mouth or eyes.

Mouth care is also important; keep the mouth clean by brushing teeth twice a day; use mouth rinses without alcohol, and do not use floss. Food safety is important as well – and it is even more vital during chemotherapy to remember tips you follow as usual such as washing hands before preparing and consuming food, cooking food well, keeping raw foods away from ready-to-eat food, wash vegetables and fruits, and keep cold food cold.

On a related note, those at highest risk for infection shouldn’t drink water that is not properly treated. Boiling water for a full minute kills cryptosporidium and other waterborne organisms.

Pay attention to white blood cell counts during cancer treatment. Your health care professional should let you know when you receive a treatment that will lower your white blood cell count, and you should ask when white blood counts are going to be at their low point, when your body will be less likely to fight off infection.

Chemotherapy and Swimming

The American Cancer Society’s message regarding exercise is clear – moderate exercise during treatment is beneficial. Chemotherapy’s side effects can reduce the motivation to exercise for some patients, though it is important to keep as active as possible. Why? Exercise can actually increase effectiveness of cancer treatment, boosting odds of survival. There are other advantages to exercise – a 1999 study showed that there was a significant decrease in fatigue among chemotherapy patients, and that there was an indication of less fear, anxiety and other psychological distress overall.

Swimming can cause accidental ingestion of water and can therefore increase the chances of obtaining cryptosporidium or other waterborne pathogens. It is important to make sure to avoid situations where you find yourself inhaling environmental spores found in and around moist, dark areas such as rotting leaves and compost piles. Public hot tubs and spas are not recommended because there are some bacteria that can survive in the warmer water. However, if the hot tub is disinfected properly, there is little to no risk.

Swimming pools and hot tubs are not the only risk – swimming in lakes, rivers and oceans can bring on recreational water illnesses. These can be spread from swallowing, inhaling and contacting contaminated waters with open eyes, or open cuts or sores. The most common recreational water illness is diarrhea. Other illnesses from contaminated water include gastrointestinal, skin and mild respiratory infections.

Pools and hot tubs that are disinfected properly can be a safer swimming experience, especially low-use residential pools – but pH and disinfectant levels should be checked on a frequent basis for disease-causing germ control, and the water should be over-filtered, with long daily filter runs.

In many cases, chemotherapy patients are fitted with a port-o-cath for injections. Cover a catheter or central line with a suitable water barrier like a Tegaderm and tape over the area fully before swimming, and change bandages after each swim.

The take-home from this is to be sure to bring up these points with your doctor. Ask about your specific case, and if swimming and/or hot tubs should definitely avoided altogether. All cancer cases and infection susceptibility vary so it is important to communicate at various stages with your doctor about when swimming during chemotherapy is beneficial or best avoided – for you.

Get your Swim On, America!

References:

“Catheters and Ports in Cancer Treatment.” Cancer.Net. N.p., n.d. Web.

Patural, Amy. “Chemotherapy 101 – Cancer Treatment.” EverydayHealth.com. N.p., 16 Feb. 2010. Web.

“Infection.” – Managing Side Effects. N.p., n.d. Web.

Facey, Dorian. “Exercise During Chemotherapy.” LIVESTRONG.COM, 21 Oct. 2013. Web.

Millehan, Jan. “Swimming & Chemotherapy.” LIVESTRONG.COM, 19 Feb. 2014.Web.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR. We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement